arthritis

Managing Osteoarthritis in Your 40s, 50s, and 60s

Kristopher Chuck Ceniza is a physical therapist who also manages Knee Force. He earned his degree in physical therapy from Cebu Doctor’s University in the Philippines and has a fiery passion for sustainable fitness and bettering lives through movement. 

Many studies have linked age as one of the primary risk factors for osteoarthritis (OA). Unfortunately, it is a progressive disease that gets worse over time, so learning how to manage your osteoarthritis in your 40s, 50s, 60s, and beyond will be crucial.

But, full disclosure: There is no definitive answer as to how fast this disease progresses. It might only take months for some whereas others take years.

While it does eventually get worse, I’m writing this guide with the mindset of helping you live the best quality of life while also delaying the progression of the disease.

To do that, I’ll walk you through the following:

  • The 6 grades of this disease
  • Tips on managing osteoarthritis in your 40s, 50s, and 60s

 

The 6 grades of osteoarthritis (OARSI)

For uniformity’s sake, keep in mind that I’m using the standard set by the Osteoarthritis Research Society International (OARSI) for these grades. The concept behind this grading system is that the cartilage damage from osteoarthritis starts on the surface. The higher the grade, the deeper the damage.

No matter what grading system you follow, however, it’s important to be aware of how the disease progresses so you can adjust your management appropriately.

  • Grade 0 – Normal joint. No signs of osteoarthritis.
  • Grade 1 – The superficial layer of your cartilage is still intact but there is mild abrasion or microscopic cracks with swelling.
  • Grade 2 – There is now a loss of small parts of your superficial cartilage with the microscopic fragments appearing in your synovial fluid. The surface of your cartilage will still appear intact.
  • Grade 3 – The cracks/abrasions are now deep enough to reach the mid zone of your cartilage. Because of this depth, the abrasions also branch out and the surface of your cartilage is now uneven.
  • Grade 4 – There is now either a separation (delamination) between the superficial layer of your cartilage and its mid zone. Conversely, there may be fissures on your superficial cartilage due to dislodged loose bodies.
  • Grade 5 – Parts of your cartilage will now be completely eroded. When people say they have bone on bone arthritis, this is what they mean. The absence of cartilage on parts of your joint may also lead to micro fractures on your bone.
  • Grade 6 – Here, you will see deformity due to changes in the contour of your bones and the subsequent changes that happen to your bone plate, connective tissues, and cartilage.

Managing osteoarthritis in your 40s

Experts and studies from the NIA, NHS and Versus Arthritis have said that many cases of osteoarthritis begins somewhere in your 40s. As this is still generally the early stages of osteoarthritis, your symptoms and their treatments will likely also be mild.

You can (and should) still exercise comfortably at this age. However, taking control of osteoarthritis in your 40s should focus on minimizing damage to your joints, strengthening your muscles, and promoting joint flexibility to slow down the progression of the disease.

Here are a few things I recommend you do:

  • Take pain meds cautiously. Even OTC NSAIDs (non-steroidal anti-inflammatory meds) have long-term side effects, so try not to abuse them. If it’s not too painful, try the RICE treatment instead (Rest, Ice, Compression, and Elevation).
  • Lose weight (if you’re overweight or obese). The less you weigh, the less burden your weight bearing joints have to carry. Plus, it’s so much easier to start losing weight now while your symptoms are still mild.
  • Walk more. Walking is a low-impact exercise that promotes endurance, strength, and flexibility. These are attributes that you will need to maintain as much as possible to get the best quality of life down the road.
  • Do other forms of exercise that you enjoy. When you enjoy your exercise, you’re more likely to make it a habit. Consistency with your exercise program is significantly more important than the type of exercise you do.

Treating osteoarthritis in your 50s

If you’re already in your 50s and your osteoarthritis has progressed, then you’re probably already on your way to moderate grades, if not already there. This should be around grade 3-4 on the OARSI grading system.

As such, your osteoarthritis pain will be more intense but not to the point where you’re non-ambulatory. So, even with a few restrictions, you should still be able to live a full life in your 50s.

Here are a few tips I recommend you try:

  • Walk with a cane (or your choice of assistive device). Consider this if your knees or hips are in constant pain when you walk. This should help keep the pain and swelling down while keeping you ambulatory.
  • Go to physical therapy. You could do this as early as your 40s but now that your symptoms are more evident, physical therapy should be at the top of your list.
  • Try Tai chi or yoga. Both of these practices are low-impact, promote relaxation, and use controlled movements, so they come highly recommended for osteoarthritis pain.
  • Wear a knee brace when doing activities. Knee braces add more support and pain relief. This is something you can consider especially since knee osteoarthritis is one of the most common forms of this disease. 
  • Use prescribed insoles. Insoles help correct the forces acting on your weight bearing joints. Ask your doctor about what type you should get to relieve pain and to help prevent future deformity.
  • Try nutritional supplements. Glucosamine and chondroitin sulfate seem to relieve pain for many people with osteoarthritis of the knee and hip. If you’re taking other medications, please get the all clear from your doctor before taking any supplements.

Coping with osteoarthritis in your 60s

If you can adequately manage your OA in your 40s and 50s, you should be deep in your 60s without your arthritis symptoms becoming severe. But, if your osteoarthritis pain and other symptoms have unfortunately progressed to severe levels, you may want to speak to your doctor about these treatments:

  • Use an unloader knee brace. This is particularly useful for painful knee osteoarthritis that’s only significantly degenerated one part of the joint. The unloader brace takes pressure away from that area, thereby relieving pain.
  • Prescription medication. These will likely be prescribed once OTC meds become ineffective. But, be careful not to abuse them. While these are stronger anti-inflammatory drugs, they also come with riskier side effects.
  • Intra-articular corticosteroid injections. This makes sure that your arthritic joint gets a high dose of steroidal anti-inflammatory drugs. Albeit effective, this should not be used too often as it weakens the structures around your joint. 
  • Surgery. This should be a last resort when you and your doctor have already exhausted all your other treatment options. Joint replacement surgery is commonly discussed when treating knee osteoarthritis and hip osteoarthritis.

Other ways to treat osteoarthritis pain: 

  • TENS – It’s an acronym for Transcutaneous Electrical Nerve Stimulation. It’s often used in physical therapy for short-term relief from joint pain but you can also purchase the machine if you find it effective. 
  • Hyaluronic acid (HLA) – Similar to corticosteroids, HLA is prescribed when OTC meds stop working. It theoretically helps lubricate your joints but results can vary. 
  • Aquatic therapy. The water’s buoyancy counters the effects of gravity. The deeper you are submerged, the less weight your joints have to carry. This makes exercise and movement in general more comfortable and pain-free. 
  • Acupuncture. Studies point to acupuncture as an effective alternative to traditional pain-relievers. One such study says it relieves your painful joint, improves mobility, and betters your quality of life. (7)
  • Paraffin. This is mostly used with osteoarthritis and rheumatoid arthritis of the hand. It can relieve pain in the short-term to help you tolerate exercise. (8)

The key to managing osteoarthritis is early detection. So, I highly recommend getting your joints checked as early as in your 40s. If you have a history of joint injury, getting checked earlier is also a good idea. 

Once a diagnosis has been made, you can then take the necessary steps to slow down the progression of the disease. 

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